Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.
Psychiatry Clin Neurosci. 2017 Apr;71(4):215-237. doi: 10.1111/pcn.12502. Epub 2017 Mar 27.
Psychiatry research has long experienced a stagnation stemming from a lack of understanding of the neurobiological underpinnings of phenomenologically defined mental disorders. Recently, the application of computational neuroscience to psychiatry research has shown great promise in establishing a link between phenomenological and pathophysiological aspects of mental disorders, thereby recasting current nosology in more biologically meaningful dimensions. In this review, we highlight recent investigations into computational neuroscience that have undertaken either theory- or data-driven approaches to quantitatively delineate the mechanisms of mental disorders. The theory-driven approach, including reinforcement learning models, plays an integrative role in this process by enabling correspondence between behavior and disorder-specific alterations at multiple levels of brain organization, ranging from molecules to cells to circuits. Previous studies have explicated a plethora of defining symptoms of mental disorders, including anhedonia, inattention, and poor executive function. The data-driven approach, on the other hand, is an emerging field in computational neuroscience seeking to identify disorder-specific features among high-dimensional big data. Remarkably, various machine-learning techniques have been applied to neuroimaging data, and the extracted disorder-specific features have been used for automatic case-control classification. For many disorders, the reported accuracies have reached 90% or more. However, we note that rigorous tests on independent cohorts are critically required to translate this research into clinical applications. Finally, we discuss the utility of the disorder-specific features found by the data-driven approach to psychiatric therapies, including neurofeedback. Such developments will allow simultaneous diagnosis and treatment of mental disorders using neuroimaging, thereby establishing 'theranostics' for the first time in clinical psychiatry.
精神病学研究长期以来一直受到对现象学定义的精神障碍的神经生物学基础缺乏理解的阻碍。最近,计算神经科学在精神病学研究中的应用在建立精神障碍的现象学和病理生理学方面显示出巨大的潜力,从而以更具生物学意义的维度重新构建当前的分类学。在这篇综述中,我们强调了最近对计算神经科学的研究,这些研究采用了理论或数据驱动的方法来定量描绘精神障碍的机制。理论驱动的方法,包括强化学习模型,通过在从分子到细胞到回路的大脑组织的多个层次上实现行为与特定于疾病的改变之间的对应关系,在这个过程中发挥了综合作用。以前的研究已经阐明了精神障碍的大量定义症状,包括快感缺失、注意力不集中和执行功能差。另一方面,数据驱动的方法是计算神经科学中的一个新兴领域,旨在在高维大数据中识别特定于疾病的特征。值得注意的是,各种机器学习技术已应用于神经影像学数据,并且提取的特定于疾病的特征已用于自动病例对照分类。对于许多疾病,报告的准确性已达到 90%或更高。然而,我们注意到,将这项研究转化为临床应用需要对独立队列进行严格的测试。最后,我们讨论了数据驱动方法发现的特定于疾病的特征在精神疗法中的效用,包括神经反馈。这些发展将允许使用神经影像学同时诊断和治疗精神障碍,从而首次在临床精神病学中建立“治疗诊断学”。